Abstract: Objective  To investigate the relationship between triglyceride glucose body mass index (TyG BMI index) and vascular calcification in patients with diabetic nephropathy (DN).  Method  A retrospective study was conducted among 424 DN patients admitted to our hospital from June 2020 to May 2024. The patients were divided into four groups based on their TyG BMI index at admission (TyG BMI Q1 TyG BMI Q4), and the differences in age, gender, vascular calcification, etc. were compared among the four groups. Logistic regression models were used to analyze the relationship between TyG BMI index and vascular calcification in patients, and conducting trend analysis and stratified analysis. The predictive value of predicting the risk of vascular calcification in DN patients was assessed using restricted cubic spline plot (RCS) analysis of TyG BMI index.  Result  The incidence of vascular calcification in DN patients was 30.90% (131/424). The median TyG-BMI index is 35.87. The incidence of vascular calcification in the TyG BMI Q1, Q2, Q3, and Q4 groups of DN patients was 27.36% (29/106), 15.09% (16/106), 33.96% (36/106) and 47.17% (50/106), respectively, with statistically significant differences (χ2=26.633, P<0.001). When adjusting for all confounding factors, compared with the Q1 group, the risk of vascular calcification increased by 1.893 times in the Q3 group (OR=2.893, 95% CI: 1.485～5.634, P=0.002), and 4.022 times in the Q4 group (OR=5.022, 95% CI:2.610～9.663, P＜0.001). Trend analysis shows that before and after model correction, the OR values of vascular calcification risk in patients with different TyG BMI groups showed an increasing trend (P trend<0.001). RCS analysis showed that there was a nonlinear association between TyG-BMI index and the risk of vascular calcification in DN patients  (Pnonlinearity=0.011).  Conclusion  In patients with DN, TyG-BMI was a risk factor for vascular calcification, and the risk of vascular calcification was significantly higher when TyG-BMI was higher than 35.87.

Key words: Diabetic nephropathy, Triglyceride glucose-body mass index, Vascular calcification